Characteristics of women without a postpartum checkup among PRAMS participants, 2009-2011

UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date


Document Type



Epidemiology | Health Services Administration | Health Services Research | Maternal and Child Health | Obstetrics and Gynecology | Women's Health


Introduction: For uncomplicated pregnancies in the United States, a healthcare visit 4 to 6 weeks postpartum is recommended to assess a woman's mental, social, and physical health. We studied whether sociodemographic characteristics and pregnancy and delivery factors were related to the likelihood of missing a postpartum checkup.

Methods: We conducted a cross-sectional analysis of 64,952 women who completed the United States Centers for Disease Control Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 6 survey in 2009-2011 from 17 states and New York City that included a Yes/No question about receiving a maternal postpartum checkup. We calculated risk ratios (RR) with 95% confidence intervals (CI) to assess the association between maternal factors and lack of a postpartum checkup.

Results: Compared to women who attended a postpartum checkup (89.4%), women who missed the visit (10.6%) were younger, unmarried, less educated, with lower income, without insurance, and smokers (all p < 0.05). Compared to women with adequate prenatal care, women with intermediate (RR 1.79 (95% CI 1.70-1.88)) or inadequate (RR 2.71 (95% CI 2.53-2.91)) care were more likely to miss the checkup. Women were more likely to miss this checkup if their infant was born at a residence compared to a hospital (RR 2.27 (95% CI 1.71-3.01)), and were less likely to miss the checkup if their newborn had a 1-week well visit (RR 0.70 (95% CI 0.61-0.81)).

Discussion: Sociodemographic factors and noncompliance with other medical care were associated with missing a postpartum checkup. Women with a high-risk of not attending a postpartum visit should be targeted for interventions to increase their accessibility to care.


Clinic visit, Obstetrics, PRAMS, United States Centers for Disease Control Pregnancy Risk Assessment Monitoring System, Postpartum, Surveys

DOI of Published Version



Matern Child Health J. 2019 Jul;23(7):903-909. doi: 10.1007/s10995-018-02716-x. Link to article on publisher's site

Journal/Book/Conference Title

Maternal and child health journal

PubMed ID


Related Resources

Link to Article in PubMed